Palatini P, Casiglia E, Pauletto P, Staessen J, Kaciroti N, Julius S
Clinica Medica 1, University of Padova, Italy.
Hypertension. 1997 Nov;30(5):1267-73. doi: 10.1161/01.hyp.30.5.1267.
Faster resting heart rate has been shown to be associated with a higher risk of developing hypertension and a greater incidence of cardiovascular morbidity and mortality. The aim of this study was to investigate the distribution of heart rate and its relationship with blood pressure and other cardiovascular risk factors in three populations. One European general population (Belgian study), one North American general population (Tecumseh study), and one European hypertensive population (HARVEST trial) were studied. Within each population, mixture analysis was used to investigate whether a mixture of two normal distributions explained the variance in heart rate better than a single distribution. In the men of all populations, mixture analysis identified a larger subpopulation of subjects with normal heart rate and a smaller one with fast heart rate. The subgroups with tachycardia had higher blood pressure and lipid levels than those with normal heart rate. In the populations in which they were measured, fasting insulin and postload glucose were also higher in the men with faster heart rate. A subgroup with tachycardia could also be singled out among the women from Tecumseh, but no relation between heart rate and blood pressure could be found. These findings show that in Western societies, high heart rate pertains to a distinct subgroup of subjects, who are more frequently men and exhibit the characteristic features of the insulin resistance syndrome. Sympathetic overactivity is likely to be the mechanism underlying this clinical condition.
静息心率较快已被证明与患高血压的风险较高以及心血管疾病发病率和死亡率较高相关。本研究的目的是调查三个人群中心率的分布及其与血压和其他心血管危险因素的关系。研究了一个欧洲普通人群（比利时研究）、一个北美普通人群（蒂康西研究）和一个欧洲高血压人群（收获试验）。在每个人群中，采用混合分析来研究两个正态分布的混合是否比单一分布能更好地解释心率的方差。在所有人群的男性中，混合分析确定了心率正常的较大亚组和心率较快的较小亚组。心动过速亚组的血压和血脂水平高于心率正常的亚组。在测量了空腹胰岛素和负荷后血糖的人群中，心率较快的男性的这些指标也较高。在蒂康西的女性中也可以挑出一个心动过速亚组，但未发现心率与血压之间的关系。这些发现表明，在西方社会，心率快与一个独特的亚组人群相关，这些人男性更为常见，且表现出胰岛素抵抗综合征的特征。交感神经过度活跃可能是这种临床状况的潜在机制。
